Cooling treatments can reduce brain damage caused by birth asphyxia
1 October 2009
Brain damage could be avoided for over 100 babies a year in the UK if infants with signs of a lack of oxygen at birth are given cooling treatment within the first 6 hours of life, according to the largest study of its kind by Medical Research Council (MRC) scientists.
Birth asphyxia occurs when a baby’s brain and other vital organs are starved of oxygen or blood at or around time of birth. In the UK approximately 1,400 infants a year, two in every thousand full-term births, are affected. Asphyxia can be difficult to detect before a baby is born and can cause serious brain damage, severe cerebral palsy and even death in around half of the most affected cases.
Co-chief investigator Dr Denis Azzopardi from Imperial College London said:
“The study builds on a 20 year body of research but gives, for the first time, irrefutable proof that cooling can be effective in reducing brain damage after birth asphyxia. Although unfortunately it doesn’t work in every case, our study showed the proportion of babies that survived without signs of brain damage went from 28% to 44% with cooling treatments – that’s a 57% increase.”
Carmel Bartley, Family Support Manager from the children’s charity Bliss said:
"This is very welcome research into an area which is known to save lives. Cooling of babies with birth asphyxia is an innovative technique already being used in some neonatal centres. This is a specialist treatment that we would like to see used more widely to ensure the very best outcomes for our most vulnerable babies.”
The randomised control trial involved 325 infants affected by birth asphyxia. Half of the newborn babies had their body temperature reduced to 33-34°C (91-93F) for 72 hours followed by gradual re-warming in intensive care. Normal body temperature is around 37°C (98F).
The Total Body Hypothermia for Neonatal Encephalopathy Trial (TOBY) received almost £1million of MRC funding and involved experts from Imperial College London, Oxford University, Leeds University, Queen's University Belfast, Nottingham University and Bristol University, as well as a large number of doctors in many hospitals across the UK and Europe.
The findings will be passed to the National Institute for Health and Clinical Excellence (NICE) who are responsible for treatment recommendations in NHS hospitals. Their interventional procedure guidance on this topic, which is currently in development, will analyse the total evidence base in this area and consider whether to recommend the use of cooling treatments in the future.
Press contact: 020 7637 6011
press.office@headoffice.mrc.ac.uk
